elderly in hospital

There is a solution that I've tried out on nurses and solves staffing shortages as well as funding problems in the NHS in England.

To do what was done in reverse in the 1980s, where nurses were recalled to university to train and only half of them were replaced on the wards, with the other half replaced by medically untrained Healthcare Assistants that now actually do the direct patient care in hospitals.

There is no training as standard in the specific requirements of the elderly and nurses do not do the direct patient care, which is done by the HCAs who are doing more and more basic medical tasks.

So recalling all university trained nurses and midwives to university to retrain as Junior Doctors in so short supply, because the NHS were working them to death with 100 hour days and do not seem to have trained up / employed new doctors enough to cover the return to sane working hours, safe for doctor and patient.

This is funded by converting all university nurse / midwife training to Junior Doctor courses and not starting any more university nursing / midwifery courses. Paying the trainee Junior Doctors a full Bursary and no Tuition Fees.

The return to ward based training of nurses from old State Enrolled Nurses, so as to give an apprenticeship. To begin with all nurses and midwives would have to be foreign nurses, with a strict employment criteria of good spoken English globally understood. Old trained SENs would be the trainers and Matrons.

Matrons teams of old trained SENs / Foreign Nurses (ward based trained only) to walk all hospital wards as a whole hospital direct supervision to maintain consistent care.

All new training to include palliative care and the special requirements of elder care.

Retrain all NHS salaried Healthcare Assistants in elder care so to forever end hospital bed blocking of the elderly who could be looked after in their homes or in hospices.

Ending the present Do Not Resuscitate Orders, used too often to withdraw treatment on those incorrectly called terminal (it is an inexact science) and treatment includes being given food and water. Full palliative care in a hospice should be done, including being helped with meals and drinks. And a proper end of life care, instead of the hideous DNRs that means being in a living death from overdose of morphine to bring about a chemical coma and left to dehydrate and starve. As it can take weeks to die of thirst, this is also not good for funding.

Also nurses trained on the ward would do the whole job as of old, instead of the NHS having to employ two people - a nurse and a Healthcare Assistant in the hospital.

Ending nurses stations and all the bureaucracy that takes hours away from direct patient care, that do not exist abroad. The only seats by patients when doing direct patient care.

The Sisters being like supermarket floor-walkers ensuring nurses are doing direct patient care when on duty and not form-filling, computer tapping, sitting behind a nurses desk well away from patients desperate for help.

Austerity should have brought these changes, instead none of this is being addressed and nursing falls ever lower in basic standards. The nurses and HCA are being made redundant anyway as more and more hospitals go bust.

As the elderly are two thirds of the 'clients' of NHS hospitals, is it not about time we started to demand this of government, who demand all public sector savings but spend ever more where it is not needed, and none where it is.

Some fanciful ideas are put on a make-believe party on my New Party page and policies on the drop down menu on my personal website
www.staffordshire-vote-english.org

The other party is real, but I can't find much about health. It is more about not wasting money on Europe and all that.

GKAL has put her finger right on the nub of the problem, when she points out that Matrons were incredibly strict, of course they were.
They themselves had come up the hard way starting at the bottom in the service.
Matrons had responsibility, with accountability, something which is sadly missing today.
They knew every trick in the book, & it was the pinnicle of their chosen profession.
Not as it is today where nurses start uny courses, & the top of their aspirations is senior admin, with short hours & top pay.
This is why there is such a clamour to fetch back the "Matron" sadly it will not work, no one nowadays would accept the sort of discipline that is required, it has been tried in a few areas, but quietly dropped.
Perhaps we all have the attidude that "jacks as good as his master"
The rot seemed to set in during thelate 60s early 70s when the old hierachy was crushed by the RCN who brought in the closing of private boarding arrangements for all nursing staff, removing Home Sisters, & at the same time it enabled the closing of nurses accomodation, & schools of nursing (lots of money saved.
the older ones of you who were in nursing in the 50s onwards might amplify

Agree that both articles are very good.

The problem that many of us face when raising concerns about care is that there really is nowhere to take the issue. My mother was in hospital last year - after suffering two collapsed vertebrae. In great pain, left unable to walk, bed sores, etc etc. Hugely unpleasant for her. These were issues that we could raise and deal with on a practical level. What we could not do anything about was the ward that mother was on. Lots of patients were in final stages of dementia (mother has all her marbles) and therefore very confused and upset for much of the day and night - lots of wondering around and constant calling out in distress. Additionally, one patient had severe hearing loss and other mental health problems and could only be 'quietened' if she was able to sit and watch the television. Only television was in room at the end of the ward. Unfortunately, this poor lady did not have any hearing aids and the volume had to be turned up to its maximum. The door to the television room could not be closed because this lady could not be left in the room on her own (as she got very upset). The television was on from early morning until after 11.00 pm. My mother and a couple of the other ladies in the ward just could not cope with the constant noise level and were often reduced to tears. At visiting times, it was impossible to hear yourself think let alone talk about anything. When we asked if would be possible to turn the television off, or at the very least down, we were told by nursing staff that this poor lady did not have anything else, and no-one to visit her and therefore perhaps everybody else could put up with it. Realise that there are difficulties with finding beds etc but it was truly horrendous and almost a form of torture for my mother.

Don't know how this kind of situation can be dealt with 'compassionately'.

Love the Telegraph article bags. Wouldn't it be great if nursing staff could prove their vocational values before being recruited?

Two very good articles. How sad that they needed to be written!

A poignant article, bagitha.

Sadly compassion, kindness, respect and empathy can rarely be taught in the classroom.

A great article Geraldine - I valued the way you moved from personal experience to a thorough, insightful and comprehensive overview. Thank you.

I'm now going to read bagitha's link .........

Fantastic article Geraldine and your point about the vibrant personalities of senior people in hospital not being noticed is spot on. Nursing staff make assumptions about the people they are dealing with, little knowing the contribution these elderly people have made to the improved conditions they are working or living in. The elderly woman I was in the next bed to, who was left to soak her bed despite frequent requests to staff to come and help her, had been a Jewish resistance fighter in the war, helping to smuggle refugees out of Germany, through France and into England. The cries in her sleep, when she was talking aloud to her each of her children in turn, made we weep - she was reliving her fear of being captured and constantly reassuring each of her children that they would be safe. Her daughters explained this to me while we sat chatting during visits time. What a privilege to have a mother who had done so much for people she didn't even know - a true heroine .... and to be reduced to those hospital circumstances!

It used to be that nurses were also seen as heroines and angels - helping people they didn't know with true compassion.

It is so distressing to turn up on a hospital visit to see our loved ones looking old and frail, not because they are ill, but because their hair hasn't been combed and tidied, they can't get to their dentures or specs, they haven't had a proper drink or meal, or no-one has bothered to talk with them all day. Some lucky patients have relatives coming in on a rota basis to care for them, especially at meal times, but some wards don't allow you in until the afternoon. If they have such rules, they need to demonstrate that they are looking after their patients properly, and not doing crazy things like removing an uneaten meal without checking why it was not eaten, and taking remedial action.

Well said, Geraldine. The points you raise should help discussion which, I would hope, will help attitudes move on and standards of care improve.

Good article by Allison Pearson in the Telegraph as well: ListenDarling

I am new to gransnet so have been wandering round loking at different topics. The correspondane re hospital care etc has outraged and hoorified me.
I trained as a nurse in the 60's. Florence Nightingale wards meant that we observed every patient as we worked on the ward. We had bed pan rounds, back rounds. Checking fluid intake and of course 'have you been today?' recorded in a bowel book!
Patients stayed in hospital much longer so wewere able to get to know our patients. Sadly because of the fast turnover this is no longer possible.

Gradually nursing began to move towards academia. They did not want to be 'doctors handmaids' but recognised and validated as professional. Training moved out of nursing school and on the wards into university.

What has happened is as a result of this.
Whilst not denying that there are many dedicated nurses, the correspondance shows there are too many bad ones. I can site the treatment of my husband and of my mother, at which I complained.

Nurses seem to think it is beneath them to see that a patient is given food and water and is kept comfortable.

Prthaps they should no longer be called nurses. Some other name perhaps not naughty ones!

Alone we can do nothing, united we could probably be listened to. I see the Daily Mail is doing its best. We need to shout loud and clear. We need to speak to the Prime Minister. It is not a question of money. Its returning to the caring attitude instilled by the teaching of Florence Nightingale. We need to rally round for the sake of thoose who can't speak up for themselves because one day it will be our turn.
Life is becoming increasingly difficult for the elderly. They are being marginalised and sidelined. Treated as a nuisance instead of being respected.

How can we go ahead?

smike have you read the post directly above yours?

I don't want to be curt with you smike but I do think you might have missed some of the postings and threads that show exactly what Gransnetters have done to get some changes.

Having read all of these stories & having commented on this very subject in a different thread?
I notice one thread running through them all, that allmost with out exception no one has complained officially in writing, with a copy to their MP.
Take it from me it makes a world of difference, I used this to complain over my wifes appalling treatment in a modern hospital, & my son used it to coplain over mine much later.
Words mean nothing in one ear & out of the other, the written word ah thats different, register it get a signature, show you mean business.
Hand wringing will get you no where, if enough do it eventually it will alter, the system will never be perfect, but it will get better.
IF by some chance you get no result send it to your local paper, & then on to all the dailys, MPs do not like being asscosiated with that sort of publicity.
A word of warning double check your facts'
Go on try it.

I wrote to my MP here in Cornwall, and though I have not received a reply directly from her I have received a notification from her office that, with my permission, they would like to direct the following to our Gransnet thread on the subject of care of our elderly in - and out - of hospital.:

Adult Social Care within Cornwall, the Chief Executive of Cornwall and Isles of Scilly PCT and also the Health Minister.

This is a bit of positive news, especially with the live webchat with Paul Burstow coming up on 1 March.

We are making our voice heard.

By the way, if you want to contact your MP below is a great website through which to do this. And....they come back to check after a fortnight to see if you've had a response!

www.writetothem.com/about-contact

Get lobbying ladies....Go Gransnet.

Carosanto

I am increasingly angy at the stories I read in the press regarding the current state of the NHS. I have just read the thread on Gransnet and already signed the TWG petition. What the hell has happened to the health service? As a recipient years ago of general surgery, (at least three ops); I received the best care ever. Now as I enter my middle 60s I dread the thought of going into hospital. I am fed up reading and hearing about individuals not receiving appropriate care and compassion. The stories about our NHS would disgrace a third world country, and whilst I have absolutely no doubt many hospitals and NHS staff are doing a wonderful job it is shameful that first hand accounts of poor and sloppy treatment are so common.

I agree wholeheartedly with all that has been said. Unfortunately this disgraceful non-caring attitude is not new. My mother died 10 years ago now and my sister and I had to fight every step of the way. The hospital care was appalling and degrading. Just one example my mother could neither speak nor move and was fed through a tube. She broke her hip whilst in hospital (thats another story) the Dr prescribed pain killers to be give on request. We had to fight to see the doctor concerned and when we asked how my mother was supposed to indicated that she needed pain killers he had no answer. We demanded painkillers to be given throughout the day just in case she was in pain. His answer was that they were addictive. The condition she was in did it really matter, would she live long enough to get addicted. Then he prescribed solid tablets OMG SHE WAS FED THROUGH A TUBE what was the matter with them. At that point I really wanted to hit him. We did finally get what we wanted. All I can say is god help any elderly person who has no relatives to speak up for them. This story has a good ending she was transferred to an intensive care Care Home paid for my the NHS. It was a wonderful place and the care was second to none. There are good people out there, we just need more of them.

Message deleted by Gransnet.

There is an article in the Daily Mail today about a granddaughter who nursed her grandmother back to health. The hospital staff told the relatives she was dying and they should say their goodbyes. GD was having none of it and slept on the floor and fed her and gave her fluids. This lady, who was written off by the NHS is now back at home with her DH.

I have not read all of the messages on this forum and may be repeating information you already have but has anyone thought of asking if this is a campaign that www.38degrees.org.uk would take up?

I am now so very cynical as life has taught me to be. I think that the treatment of the elderly, in particular, in hospitals is to encourage them to welcome euthanasia. This option is being actively encouraged now by some very outspoken and well known people.

The baby boomers are a drain on the nation 'they say'. The elderly do not contribute to society 'they say'. Life expectancy is at its hightest ever 'they say'.

Most people have such a short stay in hospital these days that they would rather say nothing of the treatment they have received and just try to put it behind them. I have spent one night on three separate occasions in hospital in the last few months and it was only on the third occasion that I took the time and trouble to write a letter of complaint. When I received a reply, following a lengthy investigation, it was to the effect that it was an overflow ward, had all new staff, and the matron had been informed of my concerns.

She apologised that I had had a 'negative experience' - not the word I would have chosen.

The bottom line is that they do not care. Any and everything is ruled by money. The worse that the National Health Service is allowed to become the more the businesses can earn/make out of the sick.

That smiley has really cheered me up. Sad life you know

Carol, my daughter said the student nurses were great when she was in hospital, treated her with respect, made eye contact and tried to help in anyway they could. Perhaps they become jaded and worn out over time or.....can of worms coming up......they don't have young families draining their energy levels before they even get to work......or does the system just slowly grind them down and burn them out? And to think they will have to work until they are nearly 70!!! The elderly will be nursing the elderly. I feel a sit -com coming on!

My MP has responded again and sent me a detailed reply to my concerns from Paul Burstow Minister for Care Services. Things seem to be happening but actions speak louder than words of course ,but I feel quite heartened as my MP Iain Wright has certainly taken up the cudgel.

Now I'll go and see what all those on the I Hate Christmas V I love Christmas forums are up to! Then Carol Singing gransnetters on Wednesday.
This site really is great. Gonna try a smiley now